From the Guidelines
The treatment for impetigo in an Aboriginal person should involve topical mupirocin or retapamulin twice daily for 5 days for mild cases, and oral antibiotics such as cephalexin or dicloxacillin for 7 days for more extensive or severe infections, as recommended by the Infectious Diseases Society of America 1. When considering treatment options, it's essential to note that impetigo can be caused by either Staphylococcus aureus or β-hemolytic streptococci, and treatment should be guided by the severity of the infection and the presence of any underlying health conditions.
- For mild, localized impetigo, topical antibiotics are often sufficient, with mupirocin or retapamulin being the preferred options 1.
- For more extensive or severe infections, oral antibiotics are necessary, with cephalexin or dicloxacillin being the first-line options for 7 days, unless methicillin-resistant Staphylococcus aureus (MRSA) is suspected or confirmed, in which case doxycycline, clindamycin, or sulfamethoxazole-trimethoprim (SMX-TMP) may be preferred 1. It's also crucial to consider cultural factors when treating Aboriginal patients, including involving family in care decisions and ensuring clear communication about the importance of completing the full course of antibiotics, even if symptoms improve quickly.
- Good hygiene practices, such as daily washing of the affected areas with soap and water, keeping fingernails short, and using separate towels and clothing, are also essential in preventing the spread of impetigo within close-knit communities 1. Overall, prompt and effective treatment of impetigo is critical in preventing the spread of the infection and reducing the risk of complications, particularly in Aboriginal communities where housing may be crowded and access to healthcare services may be limited.
From the FDA Drug Label
INDICATIONS AND USAGE Mupirocin ointment, 2% is indicated for the topical treatment of impetigo due to: Staphylococcus aureus and Streptococcus pyogenes. The treatment for impetigo is topical mupirocin ointment, 2%.
- The drug label does not specify any differences in treatment for Aboriginal persons, so the same treatment can be applied. 2
From the Research
Treatment for Impetigo in Aboriginal People
The treatment for impetigo in Aboriginal people is similar to that for the general population, with a focus on topical antibiotics.
- Topical antibiotics such as mupirocin, retapamulin, and fusidic acid are effective treatments for impetigo 3, 4, 5.
- Oral antibiotic therapy can be used for impetigo with large bullae or when topical therapy is impractical, with options including amoxicillin/clavulanate, dicloxacillin, cephalexin, clindamycin, doxycycline, minocycline, trimethoprim/sulfamethoxazole, and macrolides 3, 4.
- However, in endemic settings such as remote Australia, the use of topical antibiotics is declining due to the rise of antimicrobial resistance, and oral and injectable antibiotic therapies are being used instead 6.
Considerations for Aboriginal People
- The high burden of impetigo in Australian Aboriginal children highlights the need for effective treatment options 6.
- The use of alternative antimicrobial therapies is being explored to address the challenges of treating impetigo in endemic settings 6.
- The choice of topical antibiotic may depend on factors such as cost and insurance coverage, with mupirocin ointment being a cost-effective option 5.